Post on 18-Feb-2016
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Benefits Overview
The information contained in this presentation is not a contract and is subject to change by the proper authorities. It should be understood that explanations in this summary cannot alter, modify or otherwise change the controlling legal documents or general statutes in any way, nor can any right by reason of any inclusion or omission of any
statement in this presentation.
Who’s Eligible
• Permanent (non-temporary) part-time employees working 20 – 29 hours per week are eligible for many benefit programs, typically without employer contributions
• Permanent (non-temporary) part-time employees working 30 to 39 hours per week or permanent full-time employees working 40 hours per week are considered to be benefits eligible
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Health Benefits
Health Benefits• State Health Plan of NC – administered by Blue Cross
and Blue Shield of North Carolina (BCBSNC)• Use any medical provider you choose
– In Network: Your costs are lower when you use a doctor, hospital or other provider from the BCBSNC Blue Options network.
– Out of Network: For other providers, your deductibles, coinsurance and copays may be higher
• Choose from two plan options:– Basic 70/30 Plan
(lower contributions, lower coverage levels)– Standard 80/20 Plan
(higher contributions, higher coverage levels)4
Basic 70/30 Plan: Highlights
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How Plan Coverage WorksPLAN DESIGN FEATURE IN NETWORK OUT OF NETWORK
Annual Deductible(Single/Family)
$933/$2,799 $1,866/$5,598
Coinsurance You pay 30% after deductible
You pay 50% after deductible, plus difference between charge and allowed amount
Preventive Care • Office visit: $35• Specialist visit: $81
Not covered
Office visits (non-preventive) • Office visit: $35• Specialist visit: $81
You pay 50% after deductible, plus difference between charge and allowed amount
Inpatient Care You pay 30% after deductible and $291 copay
You pay 50% after deductible and $291 copay
Emergency Room You pay 30% after deductible and $291 copay
You pay 30% after deductible and $291 copay
Standard 80/20 Plan: Highlights
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How Plan Coverage WorksPLAN DESIGN FEATURE IN NETWORK OUT OF NETWORK
Annual Deductible(Single/Family)
$700/$2,100 $1,400/$4,200
Coinsurance You pay 20% after deductible
You pay 40% after deductible, plus difference between charge and allowed amount
Preventive Care • Office visit: $30• Specialist visit: $70
Not covered
Office visits (non-preventive) • Office visit: $30• Specialist visit: $70
You pay 40% after deductible, plus difference between charge and allowed amount
Inpatient Care You pay 20% after deductible and $233 copay
You pay 40% after deductible and $233 copay
Emergency Room You pay 20% after deductible and $233 copay
You pay 20% after deductible and $233 copay
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Both PPO Plans – More Details• Prescription coverage provided by Medco:
– Generic: $12 co-pay, up to 30-day supply– Preferred Brand-name: $40 co-pay, up to 30-day supply– Non-preferred Brand-name: $64 co-pay, up to 30-day supply– Specialty: 25% coinsurance up to $100, 30-day supply
• NC HealthSmart: voluntary program offering tools and resources to help you live a healthier life such as: – Member Focus newsletter, information on the 24-hour nurse
line, the Stork Rewards program, Eat Smart, Move More, Weigh Less program
• Sign up for the State Health Plan Member Newsletter at www.shpnc.org
Monthly Rates for Health Coverage
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Medical Coverage
PLANEMPLOYEE
ONLYEMPLOYEE+ CHILDREN
EMPLOYEE+ SPOUSE
EMPLOYEE + FAMILY
Basic PPO $0.00 $198.06 $510.32 $543.54
Standard PPO $22.76 $286.16 $629.64 $666.18
NCFlex Health & Other Insurance Programs
NCFlex Health & Other Insurance Programs
• These voluntary programs provide a variety of plans to meet the needs of you and your family
• You pay the full cost of coverage through payroll deductions on a pre-tax basis
• Programs include: Dental, Vision, Health Care Flexible Spending Account, Dependent Day Care Flexible Spending Account, Cancer, Critical Illness, Group Term Life Insurance, Core AD&D and Voluntary AD&D Insurance
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Dental Coverage• Coverage provided through United Concordia• Choose from two plan options:
– High Option: Includes orthodontia for children under 19– Low Option: Does not include orthodontia
• Under both options:– Visit any provider– You are responsible for deductibles– You or your dentist may file claims– You may be subject to a waiting period before certain
benefits are payable under the plan (see “Benefit Waiting Period” chart under Dental coverage on NCFlex website)
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Dental Coverage
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How Plan Coverage Works under Each OptionPLAN DESIGN FEATURE HIGH OPTION LOW OPTION
Annual Deductible $50 person/$150 family $25 person/$75 family
Preventive/Diagnostic Services• Exams, cleanings, X-rays, etc.
Plan pays 100%, no deductible
Plan pays 100% after deductible
Basic Services• Fillings, extractions, endodontics,
periodontics
• Most services: You pay 20% after deductible
• Periodontic: You pay 50% after deductible
• Fillings and extractions: You pay 50% after deductible
• Periodontic and other services: You pay 50% after deductible
Major Services• Crowns, inlays, dentures, bridges
You pay 50% after deductible Not covered
Maximum Annual Benefit $1,250 per person (excluding orthodontia)
$1,000 per person
Orthodontia for dependent children under age 19
Plan pays 50% up to $1,500 lifetime benefit per person
Not covered
Monthly Rates for Dental Coverage
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Dental Coverage
PLANEMPLOYEE
ONLYEMPLOYEE + SPOUSE
EMPLOYEE + ONE CHILD
EMPLOYEE + TWO OR MORE
CHILDREN FAMILY
High Option $37.40 $75.00 $71.96 $90.96 $132.42
Low Option $21.34 $43.04 $41.30 $52.62 $73.68
Vision Coverage
• Coverage provided through Superior Vision Services (SVS)
• Choose from three coverage options:– Exam and Materials– Materials Only– Enhanced Exam and Materials
• Under all options, visit any provider but lower expenses with SVS in-network provider
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Vision Coverage: Exam and Materials Plan and Enhanced Exam and Materials Plan
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How Plan Coverage WorksPLAN DESIGN FEATURE IN NETWORK OUT OF NETWORK
Routine Eye Exam Plan pays 100% after $20 copay
Plan pays up to $44 for ophthalmologist; up to $39 for optometrist
Frames – once every 12 months
Plan pays up to $100 ($150 for Enhanced Plan); 20% discount on coverages
Plan pays up to $50 ($81 for Enhanced Plan)
Lenses Plan pays 100% Plan pays up to:• Single vision: $34• Bifocal: $48• Trifocal: $64• Lenticular: $88
Contact Lenses (elective) Plan pays up to $120 ($150 for Enhanced Plan)
Plan pays up to $100
Contact Lenses (necessary) Plan pays 100% Plan pays up to $210
Vision Coverage: Materials Only Plan
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How Plan Coverage WorksPLAN DESIGN FEATURE IN NETWORK OUT OF NETWORK
Routine Eye Exam Not covered Not covered
Frames – once every 24 months
Plan pays up to $100; 20% discount on coverages
Plan pays up to $50
Lenses Plan pays 100% Plan pays up to:• Single vision: $34• Bifocal: $48• Trifocal: $64• Lenticular: $88
Contact Lenses (elective) Plan pays up to $120 Plan pays up to $100
Contact Lenses (necessary) Plan pays 100% Plan pays up to $210
Monthly Rates for Vision Coverage
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Vision Coverage PLAN EMPLOYEE ONLY FAMILY
Exam and Materials $6.84 $17.38
Materials Only $5.14 $12.72
Enhanced Exam and Materials $9.98 $25.10
Health Care Flexible Spending Account• Coverage provided through P&A Group• Set aside money through pre-tax contributions to pay for eligible
out-of-pocket medical, dental and vision expenses:– Deductibles– Co-pays and coinsurance– Out-of-network expenses– Uncovered procedures
• Contribute from $120 to $2,500 per year• Convenience card (debit card) for all participants• “Use it or lose it” rule; you forfeit any unused contributions
– Expenses can be incurred between January 1, 2013 and March 15, 2014, provided you remain actively employed for all of 2013. Prior year claims must be submitted by April 30, 2014.
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Dependent Day Care Flexible Spending Account
• Set aside money through pre-tax contributions to pay eligible child care and adult day care expenses so you (and your spouse) can work or attend school full-time:– Care of dependent children under age 13– Care of dependent adult who lives with you at least 8 hrs/day
• You may contribute from $120 to $5,000 per year• “Use it or lose it” rule: you forfeit any unused contributions
– Expenses can be incurred between January 1, 2013 and March 15, 2014, provided you remain actively employed for all of 2012. Prior year claims must be submitted by April 30, 2014.
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Other NCFlex Health Programs• Cancer Insurance provided through American
Heritage Life: pays benefits for cancer-related expenses– Employee Only or Employee + Family Coverage– Low, High and Premium options
• Critical Illness Insurance provided through Met Life: pays lump sum benefit in event of certain health conditions – Employee, Spouse, Children or Family Coverage– Three categories of coverage available
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Monthly Rates for Cancer Coverage
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Cancer InsurancePLAN EMPLOYEE ONLY EMPLOYEE + FAMILY
Low Option $6.78 $11.26
High Option $15.68 $26.06
Premium Option $21.64 $35.96
Monthly Rates for Critical Illness Coverage
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Critical Illness CoverageAGE EMPLOYEE SPOUSE
Less than 25 $1.50 $1.5025-29 $1.80 $1.8030-34 $2.84 $2.8435-39 $5.10 $5.1040-44 $9.14 $9.1445-49 $16.04 $16.0450-54 $25.80 $25.8055-59 $40.34 $40.3460-64 $61.20 $61.2065-69 $93.14 $93.1470-74 $134.84 $134.8475-79 $190.94 $190.9480-84 $239.70 $239.70
85 and older $257.54 $257.54
Employees may also cover eligible dependent children. Employee will pay one flat rate ($0.92) no matter how many children are covered.
Voluntary Group Term Life Insurance
• Group Term Life provided through ING: coverage in $10,000 increments, from $20,000 to $500,000 (limited to five times your base annual earnings)
• Coverage over $100,000 subject to Evidence of Insurability (EOI)
• Coverage available for yourself only
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Monthly Rates for Life Insurance Coverage
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Voluntary Group Term Life InsuranceYOUR AGE RATE PER $1,000 OF COVERAGE
Under 24 $0.049
25-29 $0.059
30-34 $0.079
35-39 $0.089
40-44 $0.139
45-49 $0.198
50-54 $0.337
55-59 $0.564
60-64 $0.840
65-69 $1.730
70-74 $2.520
Accident Insurance• Core Accidental Death and Dismemberment (AD&D)
Insurance provided through A.C. Newman– Elect coverage of $10,000 for yourself only– University pays full cost of coverage; however, you must
enroll for coverage– Payment to your beneficiaries in case of your accidental
death– Payment to you in case of your accidental dismemberment
• Voluntary AD&D Insurance provided through A.C. Newman– Elect coverage up to $500,000 for you and your family
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Monthly Rates for Accident Insurance
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Accidental Death & Dismemberment (AD&D) Insurance (Examples)BENEFIT AMOUNT EMPLOYEE ONLY COVERAGE EMPLOYEE + FAMILY COVERAGE
$50,000 $0.96 $1.50
$75,000 $1.42 $2.26
$100,000 $1.90 $3.00
$125,000 $2.38 $3.74
$150,000 $2.86 $4.50
$175,000 $3.32 $5.26
$200,000 $3.80 $6.00
$250,000 $4.76 $7.50
$300,000 $5.70 $9.00
$350,000 $6.64 $10.50
$400,000 $7.60 $12.00
$500,000 $9.50 $15.00
Income Protection Programs
Income Protection Programs
• Programs designed to provide you and/or your family with financial protection in the event of your death, disability or long-term illness
• Some are offered at no cost to you; others require you to pay for coverage
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Disability Plans• Disability coverage provided under the Disability Income Plan of
North Carolina (DIP-NC)• Short-Term Disability
– Provided to eligible employees at no cost• After one year of contributing membership to TSERS or participation
in the ORP.– Pays 50% of base compensation up to $3,000/month– Payable up to 365 days, after 60-day waiting period
• Long-Term Disability – Provided to eligible employees at no cost
• After five years of contributing membership to TSERS or participation in ORP
– Pays 65% of base compensation up to $3,900/month– Payable as long as you remain permanently disabled,
until eligibility for unreduced service retirement29
Supplemental Disability Plans• Can help fill gaps in State coverage
– Replacement income while you are ineligible for state Short-Term Disability Plan
– Waiting period: 90 days– Pays 66-2/3% of gross monthly salary up to $10,000
• Voluntary benefit; you pay full cost of coverage after-tax
• Coverage through The Standard if you elect ORP– Includes continuing ORP contributions into your ORP account on
your behalf
• Coverage through Liberty Mutual if you elect TSERS
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Retirement Programs
Retirement Programs• Participation in a retirement program is mandatory• You may choose between:
– The North Carolina Teachers' and State Employees' Retirement System (TSERS), a defined benefit plan or
– the UNC Optional Retirement Program (ORP), a defined contribution plan
• You must make your election between TSERS and ORP within 60 days of your date of hire
• Once you make the choice it cannot be changed; it is irrevocable
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TSERS Plan Highlights
• Defined benefit plan• State controls the investment• Benefit you receive is based on a formula
(factors include your age, your average final compensation and your years/months of creditable service)
• You must contribute 6% of your pay on pre-tax basis
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ORP Plan Highlights• Defined contribution plan• You control your investments• The benefit you receive at retirement is based on
investment performance and payment option chosen• Program serves as an alternate option to TSERS for certain
faculty and EPA non-faculty and other employees as approved by the UNC Board of Governors
• You must contribute 6% of your pay on a pre-tax basis• The University contributes 6.84%• Choose from four investment providers (Fidelity
Investments, Lincoln Financial Group, TIAA-CREF and VALIC)
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Retirement Plan Resources
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To review the booklet in greater detail, click on the picture to open the document.
Your Retirement, Your Choice Video
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Retirement Plan Resources
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Two more resources to assist you in making a decision between TSERS and the ORP. Click on the either image to open a link to that tool.
Supplemental Retirement Plans• Allows you to put money away on a pre-tax basis for your retirement in
addition to the 6% you contribute to TSERS or the ORP• There are three types of plans available
– 403(b) plan administered by two different vendors, Fidelity and TIAA-CREF, and sponsored by the University
– A 401(k) plan administered through Prudential and sponsored by the State of North Carolina
– A 457 plan administered through Prudential and sponsored by the State of North Carolina
• You may elect to begin, change the amount you contribute or stop your participation at anytime
• You may elect to participate in the 403(b), 401(k) and the 457 at the same time, however there are limits to the amount you can contribute
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• Full-time faculty and staff who are eligible for membership in the retirement system are eligible to enroll in two courses per academic year at a reduced rate, subject to approval by the employee's supervisor and Human Resources.
Tuition Assistance Sitehttp://
www.wcu.edu/about-wcu/campus-services/human-resources-and-payroll/general-hr-resources/benefits/tuition-assistance.asp
WCU Employee Tuition Waiver
Enrolling in Your Benefits
When Coverage Becomes Effective
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Coverage Effective DatesPLAN NAME COVERAGE EFFECTIVE
Health Benefits First of the month or first of the second month following employment
date
NCFlex Benefits First of the month following employment date
Short-Term Disability After one year of contributing membership to TSERS or ORP
Long-Term Disability After five years of contributing membership to TSERS or ORP
Supplemental Disability Plan Employment dateTSERS Employment dateORP Employment dateSupplemental Retirement Plans May enroll at anytime
Enrollment for Health Benefits• You must enroll within 30 days of your employment date• To enroll follow the instructions in the Employee Instructions for
Completing Your Benefit Enrollment Online: – http://shpnc.org/library/pdf/ebenefitsnow-enrollment-inst.p
df• Link to your campus dedicated enrollment site
– http://shpnc.org/library/pdf/hr-intouch-urls.pdf• Health insurance premiums are paid one month in
advance of coverage – (i.e., January premiums pay for February coverage)
• No pre-existing condition exclusion or waiting periods if you enroll when first eligible
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Enrollment for NCFlex Programs
• To enroll visit the NCFlex Enrollment Website– http://www.ncflexonline.org
• All employees must complete online enrollment within 30 days of their employment date.
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Enrollment for Income Protection Programs
• All employees must complete online enrollment within 60 days of their employment date
• Enroll for Supplemental Disability Insurance (after-tax) through The Standard, if you choose the UNC ORP, by completing the enrollment forms located online at http://www.northcarolina.edu/hr/unc/benefits/financial/index.htm
• Enroll for Supplemental Disability Insurance (after-tax) through Liberty Mutual, if you choose TSERS, by completing the enrollment forms located online at http://www.northcarolina.edu/hr/unc/benefits/financial/index.htm
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Enrollment in TSERS• You do not need to complete an enrollment form for
TSERS, but will be automatically enrolled. • You must designate a beneficiary by completing the
following forms: – Form 2DB - Designating Beneficiary(ies) for the Death Benefit – Form 2RC - Designating Beneficiary(ies) for The Retirement
System Return of Contributions – For these two forms visit
https://orbit.myncretirement.com/Orbit/Info/Pages/ListAllForms.aspx?formCat=F3BENDESG
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Enrollment in the ORP• You must complete the following forms:
– Form ORP-1 The University of North Carolina Optional Retirement Program (ORP) Election And Forfeiture Agreement
– ORP Carrier Enrollment Application (Complete the ORP Carrier form(s) for the carrier you want for your contributions and the University contributions.)
• Follow the instructions provided by your campus Human Resources/Benefits Office for instructions on where to return forms
• You must enroll within 60 days of your date of hire or you will automatically be enrolled in TSERS
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Enrollment in theSupplemental Retirement Plans
• 403(b) Plan– Visit
www.northcarolina.edu/hr/ga/benefits/retirement/Suppmtl-Ret/403bMain.htm
– Complete a Salary Reduction Agreement (form and instructions available on the website)
– Enroll in the Plan with Fidelity and/or TIAA-CREF• 457 Plan
– Visit www.retirement.prudential.com/cws/ncplans– Complete an NC 457 Deferred Compensation Plan Enrollment Form
(forms and instructions available on the website)– Send the form to:
• NC Plans Processing Center, PO Box 5340, Scranton, PA 18505, or fax to 1-866-439-8602
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Enrollment in the Supplemental Retirement Plans
• State 401(k) Plan– Visit www.retirement.prudential.com/cws/ncplans– Complete an NC 401(k) Plan Enrollment Form
(forms and instructions available on the website– Send the form to:
• NC Plans Processing Center,PO Box 5340 Scranton, PA 18505,
or fax to 1-866-439-8602
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For More Information
• Visit www.northcarolina.edu/hr/unc/benefits/index.htm for more information about the benefits provided by The University of North Carolina system.
• You can also check http://www.wcu.edu/12305.asp for WCU’s HR and Benefits Office contacts.
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